A highly motivated Credit, Administrative, Manager, Teacher, H/R , A/R, A/P, Buyer, and Collections professional with a verifiable record of accomplishment spanning ten years. Highly creative, recognized as a results-oriented and solution-focused individual.
Charismatic and dependable Teacher with 15 years of experience delivering educational assistance and instruction to various levels of learners. Committed to providing students with necessary tools to achieve academic goals, instilling love of learning and cooperative teamwork. Adept in application of excellent communication and problem solving skills. Stress and time management ability Leadership Skills I have been able to motivate people to reach the company goals. I also have provided tips on how to reach certain goals within the company. I can better help the employees in learning new strategies and ideas for the growth of the company. I believe that I'm a proficient mentor and I'm a patient listener as well. In the past ten years I have found different ways and skills to achieve my goals and the company's goals. I have utilized my education and demonstrated different abilities that have taught other team members and motivated the team members while maintaining accomplishments and interests within the company. Overall, my leadership have influence other members on my team to complete a goal at high standards.
Flexibility, adaptability and the willingness to learn new skills
Ability to deal with sensitive people management issues effectively
Audio-visual aid implementation
Positive Learning Environment
Teacher08/2018 to Current Chatman's Christian Academy – Jacksonville, Florida
Evaluated and revised lesson plans and course content to facilitate and provided moderate classroom discussions and student centered learning.
Fostered team collaboration between students through group projects for Reading, History and Language Arts.
Boosted student grasp of materials with weekly tutoring sessions during class time.
Observed and evaluated students' performance, behavior, social development and physical health.
Enhanced student learning by optimizing wide range of instructional approaches and innovative classroom activities.
Reviewed curriculum and devised alternate approaches to presenting lessons to increase student understanding.
Instituted mentoring program between 4th- 12th -grade students, increasing student development and enthusiasm for learning.
Promoted physical, mental and social development by implementing classroom games and outdoor recreational activities.
Developed and deepened relationships with students, family members and faculty to promote optimal student learning environments.
Encouraged interactive learning by incorporating educational software and online assignments.
Prepared lesson plans according to assessment of student needs and learning ability.
Claims Examiner01/2015 to Current WellCare Health Plans Inc. – Tampa, FL
Responsible for timely and accurate processing of all Medical and Medicare while sustaining 100% production and maintaining a quality score of 97% or better
Utilize all available resources for effective decisions to properly adjudicate claims
Experienced in both professional and institutional claims
Accurately evaluate and price professional non-par Medicare claims per CMS guidelines
Followed adjudication policies and procedures to ensure proper payment of claims in a timely manner
Experienced in sending system generated letters to providers through different software systems
Audit claims for accuracy
Review and process provider claim appeals or adjustments
Submit medical records for authorization, case and DRG reviews
Assist supervisor with reports and special projects
Audit and finalize claims adjudicated by SAT Knowledge
Knowledgeable of all system procedures and HIPPA policies
Effective problem solver when dealing with complex claims
Possesses strong oral and written abilities in addition to demonstrating excellent organizational and planning skills
Extremely knowledgeable of ICD-9, HCPCS coding, Medical terminology and CPT-4 coding
System knowledge includes Microsoft Office, Power Points, Excel, Diamond, and Xcelys
Extremely knowledgeable Medical Coverage Guidelines, Claim Checks, Outlook and Health Care Legislation requirements
Assisted with process improvement for Diamond database
Proficient in keying claims, reopens and processing suspense and hold code claims, experience with multiple lines on claims
Audit claims within department to identify payment errors and provide effective feedback to peers on many projects that was assigned
Other abilities included providing additional claim support for Audit team when required on many projects
Scorer01/2013 to Current Scorer
Kelly Services – Jacksonville, Florida
Scored essay and reading tests from upper elementary through high school
Scored test accurately by the given test protocols
Qualified to score Expository, Persuasive, Literary, Short Answer Responses and assigned appropriate scores
Evaluated student responses to open-ended questions in a reliable manner and rates according to customer supplied scorer guide
Always in top 10% of the projects quality control standards
Educator/ Lead-Teacher01/2015 to 06/2018 Academy of Scholars – Jacksonville, FL
Established clear learning objectives based on required district curriculum
Developed and implemented an individual classroom style conducive to learning
Created innovative classroom presentations to teach sometimes complex concepts
Developed weekly lesson plans based on student objectives and curriculum standards
Evaluated student progress and addressed individual learning issues
Provided feedback to students and established productive communications with parents
Responded to inquiries from administration district official's parents and students
Established clear classroom guidelines and kept parents informed of learning goals
Provide small group and one-to-one social-emotional skills development programs and attendance coaching to elementary, middle and high school youth
Support and/or conduct extended day programming through facilitation of enriching activities for students before, during, and after school including, but not limited to, academic enrichment and intervention, homework support, recreation, service learning and leadership development
Create, support and/or co-lead events or programs to recognize and appreciate significant growth and/or achievement in social-emotional development and positive behavior
Contributing to overall school performance by engaging parents, coordinating enrichment programs for students, serving as role models and helping to enhance the school culture
Supporting and developing thematic events to engage community stakeholders
Supporting, creating and/or co-leading events or programs that recognize and appreciate significant growth and/or achievement in attendance
Doctorate of Public and Adminstration: Public and Adminstration minor
Terrorism, Mediation and PeaceExpected in 2021Walden University-
Missouri City, MO
Masters: Intelligence Studies2012American Military University-
Bachelor: Interdisciplinary of Social Science2010Florida State University-
Associate of Arts2006Florida Community College of Jacksonville-
Willing to relocate
, Authorized to work in the US for any employer
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Companies Worked For:
Chatman's Christian Academy
WellCare Health Plans Inc.
Academy of Scholars
American Military University
Florida State University
Florida Community College of Jacksonville
Job Titles Held:
Doctorate of Public and Adminstration : Public and Adminstration minor
Terrorism, Mediation and Peace Expected in 2021 Masters : Intelligence Studies 2012 Bachelor : Interdisciplinary of Social Science 2010 Associate of Arts 2006
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